Summit Nomination Application

Presdential Summit on Entreprenuership Nomination Application

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Entreprerneurship Summit Nomination Application

OMB: 0690-0026

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Nomination Form



Please use this form to nominate yourself or another entrepreneur for participation in the Entrepreneurship Summit.



Nominee Information

Please enter the following about yourself or your nominee:

  • First Name

  • Last Name

  • Email

  • Phone Number

  • Employer/Organizational Affiliation

  • Title

  • Sector (Government, Technology, Non-Profit, Foundation, Academia)

  • Country of Citizenship

  • Country of Residence (if Different)

  • No. of Years of Entrepreneurship/Entrepreneurship Support Experience

  • Gender (M/F)

  • Mailing Address

  • Website (optional)

  • Check All that Apply:

    • I (or my nominee) am an entrepreneur

    • I (or my nominee) work for an organization or business that provides services or funding to entrepreneurs

  • Please attach your or your nominee’s resume or CV, letters of support, and/or any other supplementary materials to support this nomination



Open-Ended Questions (if nominating yourself):

  • Describe what your organization or business does and your role in that organization or business in 250 words or less.

  • What unmet need does your organization or business fill? How is it entrepreneurial or how does it support entrepreneurship?

  • How have you partnered with others to improve support structures for entrepreneurs within your organization or business or for entrepreneurs who are served by your organization or business?

  • What is an example of a model policy in your country, region or even globally that enhances entrepreneurship and could be implemented elsewhere? Alternatively, what is a policy barrier to entrepreneurship in your country or elsewhere that should be removed?

  • Describe one service or program that you work on at your organization or business that could potentially contribute to fostering entrepreneurship opportunities in Muslim communities across the world after the Summit?


Open-Ended Questions (if nominating someone else):

  • Describe what your nominee’s organization or business does and their role in that organization or business in 250 words or less.

  • What unmet need does your nominee’s organization or business fill? How is it entrepreneurial or how does it support entrepreneurship?

  • How can your nominee, through their role at their business or organization, potentially contribute to fostering entrepreneurship in Muslim communities across the world after the Summit?

  • What else is important to know about the person you are nominating and why they would be a good delegate to the Presidential Summit on Entrepreneurship?



Nominator Information (If you are nominating someone else, please answer the following questions about yourself):

  • First Name

  • Last Name

  • Employer/Organizational Affiliation

  • Title

  • Country of Citizenship

  • Country of Residence (if Different)

  • Email

  • Phone Number

  • Relationship to Nominee

  • Brief Description of Your Experience in Entrepreneurship







File Typeapplication/msword
File TitleFeedback on Topics and Summit Structure Landing Page Fields
AuthorCharlie Anderson
File Modified2009-10-19
File Created2009-10-19

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